RÉSUMÉ
The paper contains comparison of sensitivity and rates of false negative results of transthoracic (TT), transesophageal (TE), and intracardiac (IC) echocardiography (echoCG) during transseptal puncture in the run of the procedure of radiofrequency ablation of atrial fibrillation. In the work fulfilled we analyzed results of 208 echocardiographical intraprocedural investigations conducted with the aim of visualization of interatrial septum (IAS) during transseptal puncture. TT, TE and IC echoCG were carried out in 32, 26, and 150 cases, respectively. Phenomenon of IAS stretching was visualized by TT echoCG in 2 (6%) cases (sensitivity 6.7%). At TE tenting phenomenon was verified in 20 patients (20%) (sensitivity 86.9%). Puncture of IAS was carried out under IC echoCG control in 127 patients. Puncture was made in the center of thin portion of IAS (in the region of fossa ovalis), in its upper and lower portions in 65, 28, and 15.7% of cases, respectively. Sensitivity of IC echoCG was 98.4%. Rate of false positive results reached 92.8, 13.04 and 1.5% for TT, TE and IC echoCG, respectively. At present IC echoCG is most sensitive and safe ultrasound technique for verification of optimal positioning of the system for conduct of transseptal puncture in the region of IAS in comparison with TT and TE echoCG.
Sujet(s)
Ablation par cathéter/méthodes , Échocardiographie/méthodes , Atrium du coeur/imagerie diagnostique , Système de conduction du coeur/chirurgie , Septum du coeur/chirurgie , Surveillance peropératoire/normes , Échocardiographie transoesophagienne/méthodes , Endosonographie/méthodes , Femelle , Études de suivi , Atrium du coeur/chirurgie , Humains , Mâle , Adulte d'âge moyen , Ponctions , Études rétrospectives , Sensibilité et spécificité , Résultat thérapeutiqueSujet(s)
Cardiomyopathie hypertrophique/chirurgie , Ablation par cathéter/méthodes , Éthanol/usage thérapeutique , Septum du coeur/chirurgie , Adulte , Cardiomyopathie hypertrophique/diagnostic , Coronarographie , Échocardiographie , Éthanol/administration et posologie , Humains , Mâle , Résultat thérapeutiqueRÉSUMÉ
We analyzed results of 175 intracardiac ultrasound studies (ICUS) in 113 men (mean age 54,6 +/- 11,0 years) and 62 women (mean age 49,7 +/- 8,9 years) with atrial fibrillation (n=146) and WPW syndrome (n=29). ICUS was used for guidance of catheters or electrodes from right to left atrium through atrial septum in 160 procedures of radiofrequency ablations for atrial fibrillation (n=146) or WPW syndrome (n=14). Complications of transseptal puncture developed in 4 patients (2,7%) with atrial fibrillation. There were no procedure related deaths. In all cases ICUS allowed to visualize interatrial septum and its thinnest part. Thus ICUS facilitates transseptal approach to the left atrium, provides lowering of risk of dangerous complications, and allows real time monitoring of possible intraprocedural complications.
Sujet(s)
Fibrillation auriculaire/imagerie diagnostique , Septum interatrial/chirurgie , Ablation par cathéter/méthodes , Échocardiographie/méthodes , Endosonographie/méthodes , Ponctions/méthodes , Syndrome de Wolff-Parkinson-White/imagerie diagnostique , Fibrillation auriculaire/chirurgie , Septum interatrial/imagerie diagnostique , Femelle , Études de suivi , Humains , Mâle , Adulte d'âge moyen , Surveillance peropératoire/méthodes , Reproductibilité des résultats , Résultat thérapeutique , Syndrome de Wolff-Parkinson-White/chirurgieRÉSUMÉ
Transthoracic and transesophagal echocardiography (TT EChG and TE EChG) were performed in 43 patients with infectious endocarditis (IE). Sensitivity and specificity of TE EChG in detection of vegetations were higher (92 and 75%, 81 and 50% for TE EChG and TT EChG, respectively). Vegetations and thromboembolism were unrelated. With TE EChG, morphologically verified perforations of valvular cusps were revealed 3 times more frequently than with TT EChG. Along with detection of vegetations and dysfunction of the prosthetic valve, an essential diagnostic marker of IE of the artificial valve is visualization of paraprosthetic fistulas in 2 of 5 patients. Indications for TT and TE EChG and techniques of their performance are described. TT EChG is used in screening for IE. TE EChG is conducted in complications of IE.
Sujet(s)
Échocardiographie transoesophagienne/méthodes , Endocardite bactérienne/diagnostic , Endocardite bactérienne/microbiologie , Infections à Pseudomonas/complications , Salmonelloses/complications , Infections à staphylocoques/complications , Adolescent , Adulte , Sujet âgé , Humains , Adulte d'âge moyenSujet(s)
Troubles du rythme cardiaque/diagnostic , Hypertension artérielle/diagnostic , Adulte , Troubles du rythme cardiaque/étiologie , Troubles du rythme cardiaque/physiopathologie , Maladie chronique , Électrophysiologie , Céphalée/complications , Céphalée/diagnostic , Céphalée/physiopathologie , Tests de la fonction cardiaque , Hémodynamique , Humains , Hypertension artérielle/complications , Hypertension artérielle/physiopathologie , Adulte d'âge moyen , PronosticRÉSUMÉ
A procedure was proposed for non-invasive mapping of the cardiac electrical potential or a spherical quasiepicardium from its synchronous multichannel measurement on the surface of the chest, i.e. routine electrocardiodraphic mapping. Mathematical simulation was used to demonstrate that the quasiepicardial potential can be calculated with the accuracy sufficient for clinical diagnosis by applying the multipole electric field resolution method with allowance made for three lowest resolution terms. Due to the fact that the spherical quasiepicardium is more approximate to the heart and more concentric as to its center than the chest surface, the maps of the quasiepicardial potential permit recognition of some features of the pattern of a cardiac electric process, which do not manifest themselves in the distribution of the potential on the body's surface. The examples showing that the assessment of a cardiac abnormality can be made more accurate by using this method are given in the paper.
Sujet(s)
Cartographie du potentiel de surface corporelle/instrumentation , Coeur/physiologie , Cartographie du potentiel de surface corporelle/méthodes , Stimulation électrique , Conception d'appareillage , Humains , Mathématiques , Modèles cardiovasculaires , Reproductibilité des résultatsRÉSUMÉ
The report presents the results of EchoCG study in 81 patients with unstable stenocardia admitted in 6-24 hours from the onslaught pain. With the help of EchoCG the myocardial contractile function was defined and the segmental kinetics of left ventricular wall was registered with respect to four variants of unstable stenocardia courses: stenocardia occurred for the first time, progressive stenocardia, variational stenocardia and postmyocardial infarction stenocardia. During the EchoCG examination at the moment of anginal attack the significant increase in left ventricular end-diastolic volume and end-systolic volume and decrease of total ejection fraction were noted. Also, not infrequently the zones of dyskinesia are recorded indicative of ischemia of these segments, which commonly have transient character. With the progress of myocardial ischemia the abnormalities of left ventricular diastolic fraction appear which are determined with the help of Doppler-EchoCG. Thus, the use of EchoCG in diagnostics of patients with unstable stenocardia allows more reliably to define the degree of myocardial changes.
Sujet(s)
Angor instable/imagerie diagnostique , Échocardiographie , Adulte , Angine de poitrine variante/imagerie diagnostique , Échocardiographie/instrumentation , Électrocardiographie , Épreuve d'effort , Humains , Facteurs tempsSujet(s)
Contusions/diagnostic , Lésions traumatiques du coeur/diagnostic , Blessures du thorax/diagnostic , Plaies non pénétrantes/diagnostic , Contusions/physiopathologie , Diagnostic différentiel , Électrocardiographie , Radiokymographie , Lésions traumatiques du coeur/physiopathologie , Hémodynamique , Humains , Blessures du thorax/physiopathologie , Plaies non pénétrantes/physiopathologieRÉSUMÉ
Based on the clinical, instrumental and biochemical findings, out of 104 patients with septic endocarditis 11 (10.6%) were diagnosed to have myocardial infarction. It was provoked by coronary artery embolism, the covering of the coronary artery ostium by vegetation from the aortal cusp, a decrease of perfusion pressure in atherosclerosis stenosed coronary arteries because of marked insufficiency of the aortal cusp. In more than half the cases, the clinical picture of myocardial infarction was atypical, painless. Echocardiographic demonstration of the vegetations near the coronary artery ostium permits forecasting the possibility of its covering with vegetation, the threat of the occurrence of acute coronary insufficiency, which may appear an additional indication for heart valve replacement.
Sujet(s)
Endocardite bactérienne/complications , Infarctus du myocarde/étiologie , Adolescent , Adulte , Sujet âgé , Tests enzymatiques en clinique , Diagnostic différentiel , Échocardiographie , Électrocardiographie , Endocardite bactérienne/diagnostic , Endocardite bactérienne/chirurgie , Femelle , Prothèse valvulaire cardiaque , Humains , Mâle , Adulte d'âge moyen , Infarctus du myocarde/diagnostic , Infarctus du myocarde/chirurgieRÉSUMÉ
The clinical effects of Tenoric, a long-acting combined drug (atenolol and chlorthalidone in a tablet), were studied in 31 patients with Stages I and II hypertensive disease, by using echocardiography, daily automatic blood pressure monitoring, bicycle ergometry, measurements of plasma renin and aldosterone. The drug was found to be highly clinically effective in labile and sustained hypertension. When given once or twice a day, it makes it possible to reliably monitor blood pressure, improve hemodynamic parameters, as reflected by lower cardiac output and decreased peripheral vascular resistance, reduce the estimated mass of the left myocardium, alleviate a pressor response to exercise and enhance its tolerance, lower plasma renin levels. The side effects of the drug are minimal and include moderate bradycardia. Peripheral vasospasm and systemic weakness were observed in single cases. There were no atherogenic changes in lipid spectrum and disturbed glucose and uric acid metabolism during the drug therapy.
Sujet(s)
Antihypertenseurs/usage thérapeutique , Aténolol/usage thérapeutique , Chlortalidone/usage thérapeutique , Hypertension artérielle/traitement médicamenteux , Adulte , Sujet âgé , Association médicamenteuse , Humains , Adulte d'âge moyenSujet(s)
Angine de poitrine/diagnostic , Angor instable/diagnostic , Adulte , Sujet âgé , Angine de poitrine variante/diagnostic , Angine de poitrine variante/traitement médicamenteux , Angine de poitrine variante/étiologie , Angor instable/traitement médicamenteux , Angor instable/étiologie , Association de médicaments , Humains , Mâle , Méthodes , Adulte d'âge moyenSujet(s)
Maladies cardiovasculaires/diagnostic , Échocardiographie , Adulte , Sujet âgé , Diagnostic différentiel , Urgences , Humains , Mâle , Adulte d'âge moyenRÉSUMÉ
With a sharp increase in the sizes of the left atrium its wall in the form of a fold can be seen behind the left ventricle. An echo-free space is recorded in such cases on echocardiograms. It can be interpreted as pericardial exudate. Proceeding from an analysis of the results of ultrasonic investigation of 5 patients the authors have proposed some criteria for differential diagnosis between the gigantic left atrium and pericardial effusion.
Sujet(s)
Cardiomégalie/diagnostic , Échocardiographie , Épanchement péricardique/diagnostic , Adulte , Insuffisance aortique/diagnostic , Diagnostic différentiel , Femelle , Atrium du coeur , Humains , Mâle , Adulte d'âge moyen , Sténose mitrale/diagnostic , Insuffisance tricuspide/diagnosticRÉSUMÉ
Two groups of patients with constrictive pericarditis were identified on the basis of clinical and instrumental examination including echocardiography and computerized tomography of the heart: patients with complete obliteration of the pericardial sac and constriction, and those with exudative/adhesive pericarditis and constriction. Part of the patients were subjected to subtotal pericardectomy. An improvement of left-ventricular diastolic function and hemodynamic parameters was demonstrated 1 to 1.5 months after the operation. Postoperative echocardiography showed persistent disorders of interventricular septum movement and multilayer abnormal echoes in the left-ventricular posterior wall area.